Optical Coherence Tomography (OCT) is a low coherence interferometric imaging modality used to obtain micron-resolution structural information in depth, however it lacks in molecular specificity, and can therefore be combined with Near Infrared Fluorescence (NIRF) imaging, using labelled monoclonal antibodies to provide molecular contrast. Here, a novel capsule endoscope design is presented, which facilitates circumferential Immuno-OCT imaging in the gastrointestinal tract. The capsule endoscope is fitted with a double clad fiber to achieve dual modality imaging. We present preliminary endoscopic data for both imaging modalities, for which we have used phantoms to validate the imaging capabilities of the capsule endoscope.
Optical Coherence Tomography (OCT) acquires micron-resolution depth information on the superficial layers of tissues, but lacks in molecular specificity. Near Infrared Fluorescence (NIRF) imaging in combination with fluorescently labelled monoclonal antibodies can provide micron-resolution molecular contrast (Immuno-OCT). Here, a novel capsule endoscope design is presented, which facilitates circumferential imaging in the gastrointestinal tract. The endoscope is fitted with a double clad fiber coupler to enable dual-modality imaging. We present preliminary endoscopic data for both imaging modalities, for which phantoms were used to validate the capsule endoscope as an Immuno-OCT imaging device.
Barrett’s Esophagus (BE) is a common pre-cursor condition to Esophageal Adenocarcinoma (EAC); the monitoring of which can facilitate the detection of dysplastic tissue, and the treatment of subsequent early stage EAC. Early detection of EAC improves survival rates significantly. Optical Coherence Tomography is a low coherence interferometric technique which produces depth scans of tissues. OCT provides morphological information, but lacks in specificity, and so can be combined with Near Infrared Fluorescence imaging, to also retrieve molecular information. Fluorescently labelled monoclonal antibodies can be administered in order to label specific tissues, which can then be imaged using this OCT-NIRF technique. Fluorescently labelled bevacizumab combined with OCT-NIRF imaging will highlight inflamed, dysplastic and pre-/cancerous tissues, such as BE tissue. Here, silicon elastomer phantoms are used to quantify the fluorescence intensity signal detected from a dilution of fluorescent bevacizumab: the fluorescent signal intensity is correlated as a function of fluorophore depth and concentration, and μ′𝑠value of the phantom material.
Significance: Near-infrared fluorescence molecular endoscopy (NIR-FME) is an innovative technique allowing for in vivo visualization of molecular processes in hollow organs. Despite its potential for clinical translation, NIR-FME still faces challenges, for example, the lack of consensus in performing quality control and standardization of procedures and systems. This may hamper the clinical approval of the technology by authorities and its acceptance by endoscopists. Until now, several clinical trials using NIR-FME have been performed. However, most of these trials had different study designs, making comparison difficult.
Aim: We describe the need for standardization in NIR-FME, provide a pathway for setting up a standardized clinical study, and describe future perspectives for NIR-FME.
Body: Standardization is challenging due to many parameters. Invariable parameters refer to the hardware specifications. Variable parameters refer to movement or tissue optical properties. Phantoms can be of aid when defining the influence of these variables or when standardizing a procedure.
Conclusion: There is a need for standardization in NIR-FME and hurdles still need to be overcome before a widespread clinical implementation of NIR-FME can be realized. When these hurdles are overcome, clinical outcomes can be compared and systems can be benchmarked, enabling clinical implementation.
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